Walmart Pharmacy 10-6579 – Pharmacy, NPI 1922532779

Walmart Pharmacy 10-6579 is a healthcare provider. based in Bentonville, Arkansas. specializing in Pharmacy. The NPI Number for Walmart Pharmacy 10-6579 is 1922532779

Main info

Organization
Name
Walmart Pharmacy 10-6579
NPI
1922532779
Phone
(479) 204-1258
Address
702 SW 8TH ST
Authorized Official
KIMBERLY CANONIC SENIOR DIRECTOR, ENROLLMENT
Enumeration Date
19 April 2017
Last Update Date
12 June 2025

Contacts

Main Contact
https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness100
Years active:9State licenses:07/7 NPPES fields on file

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Provider Addresses for Walmart Pharmacy 10-6579

  • Walmart Home Office Main Entrance, 702, Southwest 8th Street, Bentonville, Benton County, Arkansas, 72712, United States

    BENTONVILLE, AR 727160445

    Phone: (479) 204-1258

    Fax: (479) 277-4331

    Type: Mailing

  • Walmart Supercenter, 20310, Loop 494, New Caney, Montgomery County, Texas, 77357, United States

    NEW CANEY, TX 77357

    Phone: (281) 306-7099

    Fax: (281) 306-7098

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-09-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-04-30 (773 days ago).

Enrollment records

1

Earliest due date

2024-04-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20170911000457OPharmacyTX2024-04-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
K1034Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count73191$0
G0008Administration of influenza virus vaccine7171$0
90662Influenza vaccine split virus, preservative free6464$0
90480Admn sarscov2 vacc 1 dose2626$0
G0009Administration of pneumococcal vaccine2121$0
View full utilization report →

Insurance plans in this area (ZIP 72716)

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Reviews

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Frequently asked questions

What is Walmart Pharmacy 10-6579's NPI number?
Walmart Pharmacy 10-6579's NPI is 1922532779 — the number used across U.S. healthcare to identify this provider.
Is Walmart Pharmacy 10-6579 still an active registrant?
Walmart Pharmacy 10-6579 carries an active NPI according to the public dataset.
What area of care is associated with Walmart Pharmacy 10-6579?
Walmart Pharmacy 10-6579's record emphasizes Pharmacy. Clinical services aligned with this taxonomy classification.
Is Walmart Pharmacy 10-6579 associated with Bentonville?
Public fields place Walmart Pharmacy 10-6579 around Bentonville, Arkansas. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for Walmart Pharmacy 10-6579 is noted as April 19, 2017 where the registry provides it.

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